Circumferential tracheal reconstruction for the functional treatment of airway compromise

Objectives/Hypothesis. The objective was to describe a surgical technique for replacement of long tracheal defects with a totally autologous free prefabricated cutaneous chondromucosal forearm tubular flap, applied to humans. Study Design: Surgical reconstruction of the trachea. Methods: A three-stage surgery was performed in a 25-year-old patient who presented with a long tracheal defect not resolved by previous resection with primary anastomosis and laser surgery. Results: The staged surgery has been well tolerated by the patient, and no problems at all were reported. The postoperative computed tomography scan and the bronchofibroscopy examination of the "neo-trachea" at 2 and 6 months revealed normal caliber, good healing of the suture lines, absence of crusts or granulation tissue, and a well-vascularized internal mucosal lining. Conclusion: The modified flap reconstruction technique has the potential to be considered reliable for the definitive circumferential reconstruction of extensive laryngotracheal defects not amenable to being cured by conventional techniques.